<div class="am-u-sm-12 widget main-w" >
	<ol class="am-breadcrumb">
		<li><a href="{:url('/admin/index')}">首页</a></li>
		<li><a href="{:url('/admin/car/index')}">业务管理</a></li>
		<li><a href="{:url('accident')}">事故管理</a></li>
		<li class="am-active">事故填报</li>
	</ol>
	<form class="am-form-inline tpl-form-border-form" enctype="multipart/form-data" data-ajax="1" data-check="1">
		<div class="am-u-sm-12 cl-p">
			<fieldset>
				<legend>事故基本信息</legend>
				<div class="am-u-sm-7">
					<div class="am-u-sm-12 cl-p margin_bottom_10">
						<div class="am-u-sm-6 cl-p">
							<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">车牌号： </label>
		
							<div class="am-u-sm-8 cl-p">
								<div class="am-u-sm-12 cl-p">
									<select name="car_id" class="tpl-form-input car" data-check='1' data-msg='请选择车辆' data-am-selected="{btnWidth: '100%',searchBox: 1}">
									</select>
								</div>
							</div>
						</div>
						<div class="am-u-sm-6 cl-p">
							<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">司机： </label>
							<div class="am-form-group am-u-sm-8 cl-p">
								<div class="am-u-sm-12 cl-p">
									<select name="driver_id" class="tpl-form-input driver"  data-check='1' data-msg='请选择司机' data-am-selected="{btnWidth: '100%',searchBox: 1,maxHeight: 200}">
									
									</select>
								</div>
							</div>
						</div>
					</div>
					<div class="am-u-sm-12 cl-p margin_bottom_10">
						<div class="am-u-sm-6 cl-p">
							<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">事故发生地点： </label>
		
							<div class="am-u-sm-8 cl-p">
								<input type="text" name="address" value="{$item.number}"  data-check='1' data-msg='请填写事故发生地点' class="tpl-form-input" style="line-height: 21px;"  />
							</div>
						</div>
						<div class="am-u-sm-6 cl-p ">
							<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">事故发生时间： </label>
							<div class="am-form-group am-u-sm-8 cl-p">
								<div class="am-u-sm-12 cl-p">
									<input type="text" name="accident_time" class="tpl-form-input accident_time"  data-check='1' data-msg='请选择事故发生时间' style="line-height: 21px;"  />
								</div>
							</div>
						</div>
					</div>
					<div class="am-u-sm-12 cl-p margin_bottom_10">
						<div class="am-u-sm-12 cl-p">
							<label class="am-u-sm-2 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">事故描述： </label>
							<div class="am-u-sm-10 cl-p">
								<textarea class="cl-p" rows="5" name="desc"></textarea>
							</div>
						</div>
					</div>
				</div>
				<div class="am-u-sm-5">
					<div class="am-u-sm-12">
						<div class="am-u-sm-12 ">
							<div class="am-form-group file-w">
								<div style="width: 150px;height: 150px;">
									<img class="fileimg pic_listfileimg" data-magnify="1" src="{if $item.driving_license_img2}{:CxImg($item.driving_license_img2)}{else/}{$static_dir}/assets/img/noimg.gif{/if}" style="width: 100%;height: 100%;" />
								</div>
								<button type="button" data-type='file' class="am-btn am-btn-danger am-btn-sm "><i class="am-icon-cloud-upload"></i> 添加事故现场图片</button>
								<input type="file"  class="pic_list" data-type='img' style="display: none;">
							</div>
						</div>
					</div>
				</div>
			
			</fieldset>
			<fieldset>
				<legend>事故处理结果</legend>
				<div class="am-u-sm-12 cl-p margin_bottom_10">
					<div class='am-u-sm-3'>
						<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">处理情况： </label>
						<div class="am-form-group am-u-sm-8 cl-p">
							<div class="am-u-sm-12 cl-p">
								<input type="text" name="handle_desc" value="{$item.number}" class="tpl-form-input" style="line-height: 21px;"  />
							</div>
						</div>
					</div>
					<div class='am-u-sm-3'>
						<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">处理结果： </label>
						<div class="am-form-group am-u-sm-8 cl-p">
							<div class="am-u-sm-12 cl-p">
								<input type="text" name="handle_result" value="{$item.number}" class="tpl-form-input" style="line-height: 21px;"  />
							</div>
						</div>
					</div>
					<div class='am-u-sm-3'>
						<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">责任认定： </label>
						<div class="am-form-group am-u-sm-8 cl-p">
							<div class="am-u-sm-12 cl-p">
								<input type="text" name="responsibility" value="{$item.number}" class="tpl-form-input" style="line-height: 21px;"  />
							</div>
							
						</div>
					</div>
					<div class='am-u-sm-3'> </div>
				</div>
				<div class="am-u-sm-12 cl-p">
					<div class='am-u-sm-3'>
						<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">定损人： </label>
						<div class="am-form-group am-u-sm-8 cl-p">
							<div class="am-u-sm-12 cl-p">
								<input type="text" name="solve_person" value="" class="tpl-form-input" style="line-height: 21px;"  />
							</div>
						</div>
					</div>
					<div class='am-u-sm-3'>
						<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;font-size: 14px;">	保险赔偿金额： </label>
						<div class="am-form-group am-u-sm-8 cl-p">
							<div class="am-u-sm-12 cl-p">
								<input type="text" name="solve_person" value="" class="tpl-form-input" style="line-height: 21px;"  />
							</div>
						</div>
					</div>
					
					<div class='am-u-sm-6'> </div>
				</div>
			</fieldset>
		</div>
		<div class="am--u-sm-12">
			{if $Think.get.id}
			<button type="button" class="am-btn am-btn-sm am-btn-primary tpl-btn-bg-color-success keep2">保存</button>
			{else/}
			<button type="button" class="am-btn am-btn-sm am-btn-primary tpl-btn-bg-color-success keep">新增</button>
			{/if}
			<button type="button" class="am-btn am-btn-sm am-btn-primary tpl-btn-bg-color-success back">返回</button>
		</div>
	</form>
</div>